tbuckley/cabot-search huggingface dataset:
Endoscopic submucosal resection with adaptative traction device: a new strategy to facilitate resection in patient with inflammatory bowel disease
Authors: Louis-Jean Masgnaux, Mathieu Pioche, Jérôme Rivory, Florian Rostain, Jérémie Jacques, Mathurin Fumery, Clara Yzet
Journal: Endoscopy (2023)

Endoscopic submucosal dissection (ESD) is well described in non-IBD (inflammatory bowel disease) patients to remove non-invasive neoplastic lesions in the colon. Data are still limited in IBD patients. One of the limited factors for the resection by ESD of dysplasia in IBD is fibrosis, which leads to an increased risk of complication such as perforation.
Abnormal bronchial artery mimicking esophageal submucosal tumor
Authors: Ou Chen, Liansong Ye, Li Zhang, Bing Hu
Journal: Endoscopy (2023)

An 80-year-old man presented with a subepithelial lesion in the middle esophagus ([Fig. 1]). He reported no significant discomfort. His medical history was unremarkable. Physical examination revealed no significant abnormalities.
A shot in the light: rendezvous endoscopic ultrasonography-guided pancreatic duct drainage in treatment of recurrent pancreatitis with pancreas divisum
Authors: Wei-hui Liu, Ke Qi, Ting Yang, Li Yang, Bo Li, Zi-lei Wu, Kai-xuan Wang
Journal: Endoscopy (2023)

A 34-year-old man with recurrent pancreatitis was referred for endoscopic retrograde cholangiopancreatography (ERCP) [1], but cannulation of the main pancreatic duct (MPD) repeatedly failed at several teaching hospitals owing to pancreas divisum and invisible minor papilla orifice ([Fig. 1]) [2]. Thus, we decided to perform rendezvous endoscopic ultrasonography (EUS)-guided pancreatic duct drainage (EUS-PD-RV) ([Video 1]).
The “squeezing with forceps” method for emergency endoscopic removal of an impacted pancreatic stone in the papilla of a patient on antithrombotic therapy
Authors: Sho Kitagawa, Shori Ishikawa, Keiya Okamura
Journal: Endoscopy (2023)

Endoscopic pancreatic sphincterotomy or needle-knife precut sphincterotomy is an essential procedure when removing a large impacted pancreatic stone in the papilla [1] [2] [3]. However, sometimes it is not feasible to perform such procedures, especially in emergency settings in patients receiving antithrombotic therapy. Herein, we report an alternative method that can be used for emergency endoscopic removal of an impacted pancreatic stone in the papilla of patients undergoing antithrombotic therapy.
Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort study
Authors: Joanna Luttikhold, Lisanne M. D. Pattynama, Stefan Seewald, Stefan Groth, Bernhard K. Morell, Christian A. Gutschow, Satoshi Ida, Magnus Nilsson, Wietse J. Eshuis, Roos E. Pouw
Journal: Endoscopy (2023)

BACKGROUND : Endoscopic vacuum therapy (EVT) is a novel treatment for esophageal perforations. This study aimed to describe initial experience with EVT of esophageal perforations due to iatrogenic cause, Boerhaave syndrome, or other perforations not related to prior upper gastrointestinal surgery. METHODS : Data from patients treated with EVT for esophageal perforation at five hospitals in three European countries, between January 2018 and October 2021, were retrospectively collected. The primary end point was successful defect closure by EVT, with or without the use of other endoscopic treatment modalities. Secondary end points included mortality and adverse events. RESULTS : 27 patients were included (median age 71 years). The success rate was 89 % (24/27, 95 %CI 77-100). EVT failed in three patients: two deceased during EVT (septic embolic stroke, pulmonary embolism) and one underwent esophagectomy due to a persisting defect. Two adverse events occurred: one iatrogenic defect expansion during sponge exchange and one hemorrhage during sponge removal. Median treatment duration was 12 days (interquartile range [IQR] 6-16) with 1 sponge exchange (IQR 1-3). CONCLUSION : EVT is a promising organ-preserving treatment for esophageal perforations, with a success rate of 89 %. More experience with the technique and indications will likely improve success rates.
Deeper endotracheal intubation offers generous views for endoscopic submucosal dissection of cervical esophageal carcinoma
Authors: Yahua Chen, Wei Liang
Journal: Endoscopy (2023)

The efficacy and safety of endoscopic submucosal dissection (ESD) for treating cervical esophageal carcinoma (CEC) are well recognized [1] [2]. However, performing ESD in the cervical esophagus remains challenging due to upper sphincter contraction and endotracheal intubation balloon compression. Herein, a deeper endotracheal intubation was applied to tackle this technical difficulty.
A “clip–thread–elastic ring” internal traction device for endoscopic submucosal dissection of a duodenal tumor
Authors: Qi Luo, Tingfa Peng, Liansong Ye, Bing Hu
Journal: Endoscopy (2023)

Duodenal endoscopic submucosal dissection (ESD) is one of the most challenging procedures. We developed a "clip–thread–elastic ring" internal traction device to facilitate ESD procedures in the duodenum ([Fig. 1]). The device consists of an endoscopic clip, a surgical thread, and an elastic ring cut with scissors from a commonly used sterile glove. Herein, we report the application of this device to facilitate an ESD procedure in a 52-year-old man with a flat tumor in the descending duodenum ([Fig. 2 a]; [Video 1]).
Early esophageal squamous cell carcinoma and diverticulum were cured simultaneously by endoscopic submucosal dissection in a patient
Authors: Xianzong Ma, Qiang Ning, Jie Zhang, Dongliang Yu, Zilin Kang, Peng Jin
Journal: Endoscopy (2023)

Early squamous cell carcinoma (SCC) in esophageal diverticula is rare, with an unclear pathogenesis [1]. Endoscopic septotomy is used to treat patients at high risk for surgical resection of a diverticulum [2], and endoscopic submucosal dissection (ESD) is recommended for selected early esophageal carcinoma [3]. ESD for early cancer in diverticula is challenging for endoscopists, as diverticula have characteristically thin walls and endoscopic treatment carries a higher risk of perforation [1] [4]. Here, we report a case of ESD curing early esophageal SCC in diverticula.
Application of a “retracting flaps” technique using a device delivery system for endoscopic removal of a pancreatic stent with 10 proximal flaps stuck in the pancreatic duct
Authors: Sho Kitagawa, Yasutaka Nakai, Daiki Oku
Journal: Endoscopy (2023)

Endoscopic pancreatic duct stenting is used for a variety of conditions. Although numerous reports have described pancreatic stent migration [1], few have detailed the proximal flaps getting stuck in the pancreatic duct [2]. Here, we report a novel technique for endoscopic removal of a pancreatic stent that can be used when its flaps become stuck in the pancreatic duct.
Endoscopic coagulation for massive bleeding from a gallbladder ulcer after endoscopic ultrasound-guided gallbladder drainage
Authors: Michihiro Ono, Shutaro Oiwa, Ryo Shibuya, Ginji Oomori, Yuki Ikeda, Tomoyuki Abe, Masahiro Maeda
Journal: Endoscopy (2023)

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is an effective treatment for high-risk surgical cholecystitis and its use is gradually becoming more widespread. According to meta-analyses, the frequency of bleeding is low (1.8–4.3 %) [1] [2]. We report a case of arterial bleeding from a gallbladder ulcer after EUS-GBD that was successfully cauterized endoscopically and hemostasis was achieved.
Zenker’s peroral endoscopic myotomy for management of large Zenker’s diverticulum
Authors: Linda Y. Zhang, Oscar Hernández Mondragón, Mathieu Pioche, Steven N. Steinway, Jose Nieto, Michael B. Ujiki, Vanessa N. VanDruff, Raymond E. Kim, Andrew Canakis, Marcel Tantau, Alina Tantau, Anamaria Pop, Jérémie Jacques, Michael Lajin, Pankaj Desai, Apurva Shrigiriwar, Michael Bejjani, Nikhil A. Kumta, Mouen A. Khashab
Journal: Endoscopy (2023)

Zenker's diverticulum peroral endoscopic myotomy (zPOEM) is a minimally invasive treatment strategy for Zenker's diverticulum, with excellent results for management of small-to-moderate Zenker's diverticulum. We evaluated its use in the management of large Zenker's diverticulum.This was a retrospective multicenter cohort study across 11 international centers including adult patients with large Zenker's diverticulum ≥ 40 mm treated by zPOEM between March 2017 and March 2022. The primary outcome was clinical success (dysphagia score ≤ 1 without need for further intervention). Secondary outcomes included technical success (complete myotomy as intended), adverse events (AEs), and rate of recurrence.83 patients (male 62.7 %, mean age 72.6 [SD 11.5] years) underwent zPOEM for treatment of large Zenker's diverticulum (median size 50 mm, interquartile range [IQR] 41-55 mm, range 40-80 mm). The zPOEM procedure was technically successful in 82 patients (98.8 %), with a mean procedure time of 48.7 (SD 23.2) minutes. Clinical success was achieved in 71 patients (85.5 %). Median (IQR) symptom scores improved significantly from baseline for dysphagia (2 2 3 vs. 0 [0-2]; P < 0.001), regurgitation (3 2 3 4 vs. 0 [0-0]; P < 0.001), and respiratory symptoms (2 [0-3] vs. 0 [0-0]; P < 0.001). Among patients achieving clinical success, only one recurrence (1.4 %) was recorded during a median follow-up of 12.2 months (IQR 3-28). Post-procedure AEs, all mild to moderate, occurred in four patients (4.8 %).This study demonstrated safe and effective use of zPOEM in the management of large Zenker's diverticulum.
Endoscopic fenestration treatment for pneumatosis cystoides intestinalis in patient with recurrent colonic intussusception
Authors: Yusuke Takahashi, Kotaro Shibagaki, Chika Fukuyama, Kousaku Kawashima, Norihisa Ishimura, Yoshikazu Kinoshita, Shunji Ishihara
Journal: Endoscopy (2023)

Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by intestinal mural pneumatized cysts that appear most commonly in the colon [1] [2]. Although primarily asymptomatic, PCI occasionally causes intussusception that usually requires surgical treatment [3] [4]. Hyperbaric or high-concentration oxygen therapy is reportedly effective, though complete remission is uncertain [5]. We present the first report of an endoscopic fenestration procedure used for successful treatment of PCI with recurrent intussusception.
A novel cap-assisted endoscopic resection device for resection of a rectal lesion in an in vitro pig model
Authors: Xuelian Gao, Panpan Liu, Mengyao Li, Ying Huang, Side Liu, Yue Li
Journal: Endoscopy (2023)

In a previous study, we proved that modified cap-assisted endoscopic mucosal resection (mEMR-C) is non-inferior to endoscopic submucosal dissection (ESD) for rectal neuroendocrine tumors smaller than 10 mm with a similar complete resection rate. In addition, mEMR-C had a shorter procedure duration time and lower hospitalization costs [1]. However, a snare needs to be precisely placed into the inner groove of the cap during the mEMR-C procedure, which is time-consuming and difficult for an inexperienced doctor. To solve this problem, we proposed a novel cap-assisted endoscopic resection device for resecting of a rectal lesion that might make the procedure much simpler and easier. In the current study, we initially explored the feasibility of this device for endoscopic resection in an in vitro pig model.
Drug use, drug use disorders, and treatment services in the Eastern Mediterranean region: a systematic review
Authors: Yasna Rostam-Abadi, Jaleh Gholami, Maral Mardaneh Jobehdar, Maryam Ardeshir, Ardavan Mohammad Aghaei, Sogol Olamazadeh, Mahshid Taj, Khalid Saeed, Ramin Mojtabai, Afarin Rahimi-Movaghar
Journal: The Lancet Psychiatry (2023)
Appendiceal lesions in serrated polyposis patients are easily overlooked but only seldomly lead to colorectal cancer
Authors: David E. F. W. M. van Toledo, Joep E. G. IJspeert, Arne G. C. Bleijenberg, Barbara A. J. Bastiaansen, Carel J. M. van Noesel, Evelien Dekker
Journal: Endoscopy (2023)

Serrated polyposis syndrome (SPS) is the most prevalent colonic polyposis syndrome and is associated with an increased colorectal cancer risk. A recent study in resected appendices of SPS patients reported that 6/23 (26.1 %) of identified serrated polyps had histological dysplasia. We evaluated the prevalence and clinical relevance of appendiceal lesions in a large SPS cohort.Prospective data from 2007 to 2020 for a cohort of 199 SPS patients were analyzed. Data were retrieved from endoscopy and pathology reports. Patients who underwent (pre)clearance colonoscopies, surveillance colonoscopies, or colorectal surgery including the appendix were separately evaluated for the presence of appendiceal lesions. The primary outcome was the prevalence of adenocarcinomas and serrated polyps/adenomas with advanced histology in the surgery group.171 patients were included, of whom 110 received endoscopic surveillance and 34 underwent surgery. Appendiceal lesion prevalence in the surgery group was 14 /34 (41.2 %, 95 %CI 24.7 %-59.3 %); none were advanced on histology. Detection rates in the (pre)clearance group were 1 /171 (0.6 %, 95 %CI 0.01 %-3.2 %) for advanced and 3 /171 (1.8 %, 95 %CI 0.04 %-5.0 %) for nonadvanced appendiceal lesions, all of which were sessile serrated lesions. During 522 patient-years of surveillance, no advanced appendiceal lesions were detected at endoscopy, and in 1 /110 patients (0.9 %, 95 %CI 0.02 %-5.0 %) was a nonadvanced lesion detected.Appendiceal lesions are common in SPS patients. The discrepancy between the endoscopic detection rate of appendiceal lesions and the reported prevalence in surgically resected appendices suggests a substantial miss-rate of appendiceal lesions during colonoscopy. Advanced appendiceal lesions are however rare and no appendiceal adenocarcinomas occurred, implying limited clinical relevance of these lesions.
Metabolic and bariatric surgery versus intensive non-surgical treatment for adolescents with severe obesity (AMOS2): a multicentre, randomised, controlled trial in Sweden
Authors: Kajsa Järvholm, Annika Janson, Markku Peltonen, Martin Neovius, Eva Gronowitz, My Engström, Anna Laurenius, Andrew J Beamish, Jovanna Dahlgren, Lovisa Sjögren, Torsten Olbers
Journal: The Lancet Child & Adolescent Health (2023)
A challenging endoscopic approach to an unexpected case of extraluminal recurrence after rectal surgery
Authors: Francesco Azzolini, Francesco Vito Mandarino, Ernesto Fasulo, Alberto Barchi, Dario Esposito, Silvio Danese
Journal: Endoscopy (2023)

Postsurgical anastomotic recurrences of colorectal cancer represent a specific type of local recurrence [1] and several theories exist regarding their pathogenesis, including positive margins, lymphatic dissemination, and implantation of tumor cells [2]. Here, we present an unusual case of anastomotic recurrence that developed in a para-anastomotic cavity and was approached endoscopically.
Baricitinib for systemic lupus erythematosus: a double-blind, randomised, placebo-controlled, phase 3 trial (SLE-BRAVE-I)
Authors: Eric F Morand, Edward M Vital, Michelle Petri, Ronald van Vollenhoven, Daniel J Wallace, Marta Mosca, Richard A Furie, Maria E Silk, Christina L Dickson, Gabriella Meszaros, Bochao Jia, Brenda Crowe, Inmaculada de la Torre, Thomas Dörner
Journal: The Lancet (2023)
Rapidly separating dissolving microneedles with sustained-release colchicine and stabilized uricase for simplified long-term gout management
Authors: Yao Yang, Zimu Li, Ping Huang, Jiachan Lin, Jinyuan Li, Kexin Shi, Jiahui Lin, Jingwen Hu, Zhuoxian Zhao, Yongkang Yu, Hongzhong Chen, Xiaowei Zeng, Lin Mei
Journal: Acta Pharmaceutica Sinica B (2023)

Despite growing prevalence and incidence, the management of gout remains suboptimal. The intermittent nature of the gout makes the long-term urate-lowering therapy (ULT) particularly important for gout management. However, patients are reluctant to take medication day after day to manage incurable occasional gout flares, and suffer from possible long-term toxicity. Therefore, a safe and easy-to-operate drug delivery system with simple preparation for the long-term management of gout is very necessary. Here, a chitosan-containing sustained-release microneedle system co-loaded with colchicine and uricase liposomes were fabricated to achieve this goal. This microneedle system was confirmed to successfully deliver the drug to the skin and maintain a one-week drug retention. Furthermore, its powerful therapeutic potency to manage gout was investigated in both acute gouty and chronic gouty models. Besides, the drug co-delivery system could help avoid long-term daily oral colchicine, a drug with a narrow therapeutic index. This system also avoids mass injection of uricase by improving its stability, enhancing the clinical application value of uricase. In general, this two-drug system reduces the dosage of uricase and colchicine and improves the patient's compliance, which has a strong clinical translation.
Giant gastric stromal tumor with predominant cystic formation misdiagnosed as gastric cyst under endoscopic ultrasonography and fine-needle aspiration
Authors: Yuyong Tan, Yi Chu, Deliang Liu, Yuqian Zhou
Journal: Endoscopy (2023)

A 78-year-old man was admitted owing to 10 days of abdominal pain. He had a history of coronary heart disease, diabetes mellitus, and hypertension. Laboratory results, including tumor markers, blood amylase, and lipase, were unremarkable. During physical examination, a mass was palpated in the left upper abdomen (from the left costal arch to the umbilicus), which had an indistinct boundary and was poorly mobile. Esophagogastroduodenoscopy revealed a bulge in the gastric fundus with an unremarkable mucosa ([Fig. 1]). Computerized tomography revealed a huge abdominal cystic mass (23.3 × 14 × 22 cm), which had an indistinct boundary with the stomach ([Fig. 2]), and distinct boundaries with adjacent organs such as the liver, pancreas, etc. Endoscopic ultrasonography revealed a hypoechoic cystic lesion with scarred hyperechoic strip, and fine-needle aspiration was performed ([Video 1]). A rapid on-site evaluation was unremarkable. The cystic fluid analysis revealed a negative stringing test, normal amylase and lipase, slightly elevated CA125 and ferroprotein, with normal CEA, CA199, and AFP. Cell block and immunocytochemistry were also undiagnosed. Surgical resection was performed ([Fig. 3]), and 3000-mL cystic fluids were aspirated intraoperatively. Postoperative histology showed a spindle cell tumor ([Fig. 4]) with necrosis and cystic degeneration, and immunohistochemical results showed positive staining of CD117, DOG1 ([Fig. 5]), and CD34, with negative staining of SMA, S100, and Ki-67 index of 25 %, and mitoschisis of 8/50 HPF. Therefore, the final diagnosis was a high-risk gastrointestinal stromal tumor (GIST). He refused imatinib treatment and died within 2 years.
Are we ready for the cold snare revolution?
Authors: Øyvind Holme
Journal: Endoscopy (2023)

Cold snare polypectomy (CSP) may eliminate the risk of perforation and cannot lead to the post-polypectomy syndrome that is associated with traditional, or hot snare, polypectomy (HSP) involving electrocautery. Extensive research has documented that the risk of bleeding after CSP for subcentimeter polyps is similar or smaller than that after HSP [1]. Meta-analyses have shown that the incomplete resection rate (IRR) is comparable between the two methods, but varies markedly between the studies (0–25 %), with significant heterogeneity [1] [2]. The quality of evidence has been rated as very low. Some of the variation is probably caused by differences in study settings, with the lowest IRRs coming from academic expert centers. Complete resection of colorectal polyps is of obvious importance. It has been estimated that 20 % of post-colonoscopy cancers may be caused by incompletely removed polyps [3].
Prognostic Value of Blood Biomarkers in Steroid-Refractory/Dependent Acute Graft-vs-Host Disease: A REACH2 Analysis
Authors: Gérard Socie, Dietger Niederwieser, Nikolas von Bubnoff, Mohamad Mohty, Jeff Szer, Reuven Or, James Garrett, Anirudh Cadapa Prahallad, Celine Wilke, Robert Zeiser
Journal: Blood (2023)

Systemic steroids are the standard first-line treatment for acute graft-vs-host disease (aGVHD), but approximately 50% of patients become steroid refractory or dependent (SR/D). Ruxolitinib is the only FDA and EMA approved therapy for patients with SR/D aGVHD. In the phase 3 REACH2 trial (NCT02913261), ruxolitinib demonstrated superior efficacy to best available therapy (BAT) in treating SR/D aGVHD, with significantly higher overall response rate (ORR) at day 28, durable ORR at day 56, and longer median overall survival. Identifying biomarkers and clinical characteristics associated with increased probability of response could guide treatment decisions. In this exploratory analysis of the REACH2 study, we developed baseline (pretreatment) and Day 14 models to identify patient characteristics and biomarkers (12 aGVHD-associated cytokines/chemokines, 6 immune cell types, and 3 inflammatory proteins) before and during treatment that affected the probability of response at day 28. Treatment with ruxolitinib versus BAT, type of conditioning, skin involvement, and age were strongly associated with increased likelihood of response in ≥1 model. Lower levels of most aGVHD and immune cell markers at baseline were associated with increased probability of response. In the Day 14 model, levels of aGVHD markers at day 14, rather than change from baseline, impacted probability of response. For both models, bias-corrected area under receiver operating characteristic (AUROC) values (baseline, 0.73; Day 14, 0.80) indicated high level of correspondence between fitted and actual outcomes. This first biomarker study in context of a randomized phase 3 aGVHD trial, highlights the potential prognostic value of select biomarkers and patient characteristics.
Cost of Cancer in Adolescents and Young Adults in the United States: Results of the 2021 Report by Deloitte Access Economics, Commissioned by Teen Cancer America
Authors: Susan K. Parsons, Theresa H.M. Keegan, Anne C. Kirchhoff, Helen M. Parsons, K. Robin Yabroff, Simon J. Davies
Journal: Journal of Clinical Oncology (2023)

The purpose of this report, commissioned by Teen Cancer America and performed by Deloitte Access Economics in 2021, was to estimate the total costs incurred by adolescent and young adults (AYAs) after cancer diagnosis in the United States (US) over their life course.The incidence of cancer in 2019 among AYAs age 15-39 years was estimated from the US Cancer Statistics Public Use Database, and relative survival was projected from the Surveillance, Epidemiology, and End Results Program. Cost domains included health system, productivity, and well-being costs. Components were estimated with published literature and pooled data from the Medical Expenditure Panel Survey from 2008 to 2012 and inflated to 2019 dollars.The economic and human costs of cancer in AYAs are substantial-$23.5 billion overall, corresponding to $259,324 per person over the lifetime. The majority of costs are borne by AYA cancer survivors themselves in the form of lost productivity, loss of well-being, and loss of life.These findings underscore the need to address the burden of cancer in AYAs through targeted programs for AYAs, such as financial navigation and health insurance literacy interventions, as well as local and national policy initiatives to address access to and enhanced coverage for clinical trials participation, fertility services, and survivorship care.